Design Challenge: Hello Grand Prize Winners

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Because you just haven't gotten enough of this contest yet ;) , please say hello to the Grand Prize winners today:

Ethan Mullis (left) is a professional designer and Type 1 diabetic. His brother-in-law and best friend Alan Johnson helped him get hired at the innovative web startup company Gnoso Inc. in Taylors, South Carolina. Last March, he also convinced the firm's CEO to let them both focus on developing a new program for diabetes. Per Alan's comments yesterday, Ethan has "made clear to me many times how the typical thinking put into diabetes design makes him feel like he's a second-class citizen." They're hoping that their winning diabetes tracking program, LOG FOR LIFE, will help change all that.

They've also asked me to put them in touch with some (as-yet-unnamed) established diabetes device vendors, so they can work on integrating their program with devices we already use. Their concept for integration with the iPhone is of course key. Go, Gnoso!

These two are apparently inseparable and always tinkering on something. The go-cart they are sitting on is their newest invention. The pair won the "under 18 category" here for their ingenious MAXIMUM SLIDE glucose test strip dispenser and disposal unit.

Max's activist mom Beth Wieder writes: "Diabetes is such a constant source of frustration for him, it was really great for him to put some constructive energy into it." Ben also has a 7-year-old first cousin with Type 1 diabetes, so he's been submersed quite a bit.

btw, Max was at Astronaut Camp at Georgia Tech on the day the winners were announced, so he got late notice that he won. Beth says he was (appropriately) "over the moon" when he heard the news.

About building the prototype, Max writes: "It was pretty cool seeing something I had imagined actually working. Thanks for having the challenge -- I had a good time!"

You're very welcome, Max!

Prize money will be in the mail soon, and both winners will be contacted by IDEO design health and wellness consultants shortly for their free "concept refinement" sessions. I'm hoping to report back later on just how these great ideas are progressing.

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I have yet to be taught about the "importance" of logs in medical school. Certainly my endocrinologist has never mentioned logs. I don't understand how historical information is useful. Seems like a lot of busy work. The only number I care about is the one on my meter now, in this moment, and my A1c. The added stress of logs isn't necessary for successful control -- in fact, I'd argue that it takes precious time away from people who should be doing more valuable and useful things to improve their health.

Rodney|2008-06-26

Your endo doesn't ask you for your meter when you go for a visit? They usually download or at least look through a number of readings so that they can get a feel for how your sugars are reading based on time of day... are you running high in the mornings, afternoons, etc. and make changes to your dosages based on that 'historical' data. I don't know that it's something to worry about and admittedly I haven't read through the log software listed above, but having historical data can be useful and may not always be available from one meter. My son and I are both type 1's and between his mom's house, my house, school and daycare there are a number of meters that he uses, including mine. So we can't simply take in one meter to his doctor and get his trends. We write everything down in a log book that he brings between various places.

Michelle|2008-06-26

Oh my gosh, I can't imagine living without a log. Busy work? No way. The number on my son's meter means very little unless you know what the reading before was. Was he high and did I correct that and now I have a good number? Was he low and we treated and now he's too high? Did he just eat lunch and was fine before and is now high? And does this happen every day? THAT is the key to being successful with diabetes. Knowing how you arrived at the number that's on your meter now. The number on your meter at this moment is meaningless without something to frame it around. and your a1c? What is that but a historical representation of your last 3 months bg's? And so what if you have that number but no way to adjust it? I'm sorry you think we should all be doing more meaningful things. Don't knock it till you try it.

LaurenK|2008-06-26

Historical information in the sense of the A1c is medically valuable but how does it help to know what your BG was at 3 p.m. last Wednesday? Last Wednesday is a distant memory for me. Every single day of my week is different, I never eat or exercise at the same time from one day to the next. I am a medical student so it's rare that I even go to sleep and wake up at the same time. I don't see how a logbook would add anything to my control. Down the road I will probably encourage patients to take a half hour walk rather than spending half an hour poring over old glucometer numbers.No, my endo has never asked to see my meter, but he is more involved in research so may not be aware of trends in clinical medicine. Are there any studies that indicate keeping a log improves long-term glycemic control?

AmyT|2008-06-26

Hi Guys,This was mainly geared for Type 2s who may not test as often, but it makes the case:http://www.diabeticconnect.com/news_articles/317

Michelle|2008-06-27

Lauren, are there studies that suggest that keeping a log isn't helpful? If you're suggesting that someone "go take a 30 min walk" it clearly shows that you have a LOT to learn about what is involved in managing diabetes and what is involved in logging.

Fritz|2008-06-27

I test myself up to 20 times(A1C= 5.3 for the last 10 years) a day and it takes up a lot of my time already. Why would i waste my time any further to put all this old historical data into a log. Most of the meters out there have a memory that stores 14 to 30 days of data and a doctor can get a very good understanding of a persons blood sugar levels with that. Just making sure that your blood sugars are in control everyday will give you a very good A1C result. No offense but i really think this design will just make being a diabetic so much more difficult and is of no use.

LaurenK|2008-06-27

I have no idea what is involved in logging, you're right, Michelle. But I have been T1 diabetic for almost 18 months and have had an A1c under 6 since 2 months after diagnosis, so I know something about management.

AmyT|2008-06-27

Lauren: only 18 months? You are probably still in the honeymoon phase, and will find (like me) that your great under-6 A1c becomes harder and harder to achieve as the years go by. This is where logging can help.

LaurenK|2008-06-27

I understand where the numbers on my glucometer come from simply by remembering what I did 3 hours ago. As for honeymoon phase, my basal C peptide is under 0.1 ng/dl so I doubt there's any endogenous insulin is giving me an edge. I've read some studies about C peptide production in type 1s after dx, and it's variable. Some people aren't producing detectable C peptide levels at dx and others continue to produce small amounts of insulin even 20+ years after dx. The honeymoon isn't uniform by any means; residual insulin production isn't always present, and it doesn't always taper off.

ACat|2008-06-28

Dear LaurenHistorical events and their graphical visualization result in visible patterns. And pattern recognition is one of the things diabetes is all about. And people, too.It took me 3 months after D-Day to find out that and how e.g.the female monthly cycle influences blood sugars. No doctor ever told me about it, but there was definitely something. Checking and comparing dates and seeing that during the first six days of my cycle I needed half the amount of insulin for the same meals and with the same activity during the same weather--helped me *not* to get into a hypo several times.Understanding the pattern allowed me to search for related information, and finding it, on the net. Now I know that from day 26-day 28 I will wake up with monstrously high values. And know I need to increase my basal rate accordingly. And I know I need to be damn careful the night before day 1. But I *do* know the pattern know. And the signs. And am not simply on a rollercoaster whose rules I do not understand.It also helped in establishing a basis for a discussion with my ob-gyn, and receiving a harmless but helpfull phytoestrogen against pms decidedly lowered my ususally much too high morning values. No more dawn raids now. No more dead days to start with. Patterns. So vital.And most software so ugly and anti-visual. Hope that Ethan's Log for Life will come to life soonBest of Luck from Germany and Thanks to Amy for the contest.Diabetes does need better design.

Fritz|2008-06-28

Amy, i was diagnosed with type 1 diabetes 30 years ago and never used a log before(A1C =5.3). If you take 30 years and add all the hours that i would spent adding all that meaningless data to my log, i would have no life. Logs are a waste of time and money. Anyway, the software is already out there so why did this guys win?

Fritz|2008-06-28

ACat, i woke up with blood sugar levels in the mid 200's every morning and realized that i'm having the Dawn phenomenon. I set my alarm for 1Am, 2Am,3Am and 4 Am. I tested myself every hour and found out that my Blood sugar was 80 at 3AM and 180 at 4AM. I'm using Levemir which is a very smooth long acting insulin and calculated the time that it takes to get to its highest peak(5 hours) and injected it at 10Pm every night.My Blood sugar has been in the 90's each morning. You don't need a log to do this.I can just see my endo read my log "eat apple 10 days ago, blood sugar 180"...what a waste of time. There is no formula that will keep your Blood sugars in control and every day is different, you have to adjust.

ACat|2008-06-28

Fritz, there may be no formula. But there are tools. And logging your sugar levels along with what you eat and do, helps. It helps me, at least, and I think that is what counts. If someone else can remember each incident and what led to it, great. I cannot. And I think that is what it comes down to: finding something that helps you as an individual to manage your diabetes, which, after all, is a highly personal thing, and no two people react the same way.I like to note down what I eat and any extra medication, and sports, and as I am a highly visual person, a line graph or a dot graph that clearly shows me, yes, since I increased my Levemir two weeks ago I have had rather more 65s at 11:OO than before. And can react accordingly.A single number does not mean anything. A string of events does.And as for why did these guys win? - The software that is out there are mainly Excel-look-alikes. Typical programmers' stuff. Very little design. One web based application (sugarstats.com) at least has got the web 2.0 feel right. And I guess that is what Ethan and his friend tried. To make life a little easier and prettier for people who care about their numbers. But need to see the big picture.

Fritz|2008-06-28

ACat i had diabetes for a long time and i know what works for me. I use easy formulas(carb to insulin ratio) that changes and are different from person to person but it works. Logs might be useful to try and figure out how to manage your diabetes when you are newly diagnosed but are a waste of time to do after you figured out your carb to insulin ratio.Can i give you little of advice on you Levemir? Divide the amount that you inject every day by 2 (injecting yourself at night and in the morning) and you will have better control.

Fritz|2008-06-28

it breaks my heart to see cheesy designs like this win a competition while there are ideas that could save lives that gets overlooked

AmyT|2008-06-28

Wow, Fritz, that's just mean. Logging may not be your thing, but the work these guys put into their program scored highest in all three criteria area, so they won the contest, fair and square. This by no means takes away from the value of the other entries. Thanks.

Jim|2008-06-30

While all these comments about the value of logging are great debate, I think someone needs to give a bigger round of appluase to the other winner here! Max Wieder has actually designed something here that I (definetley not a kid!) would shell out hard earned cash for! While I agree that the search for a cure is the most critical, the search for quality and USABLE tech, that adds to our quality of life, and adhearance to our maintenance regimen is just as important!The "slider" is pure genius! My One-Touch Ultra Mini, and the included mini lancet device are wonderful, but the missing element was a small and easy to use container and dispenser for the STRIPS!Congratulations Max! I can't wait until you go into production!

Beth Wieder (mother of Max)|2008-07-01

Thanks, Jim, for the vote of support! While we're also hopeful of a cure, in the meantime we've all got our lives to live, and we're very proud of Max for thinking of a way to make the wait a little more comfortable.

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